Mesotherapy for Facial Rejuvenation

Insights from Dr. Adam Rotunda

Because skin is the largest, most visible indicator of aging, patients increasingly turn to dermatologists for advice and information about keeping skin looking healthy, supple, and firm as they age. Even as recently as 10 years ago, that meant plastic surgery – expensive, deeply invasive procedures with extensive risk and recovery time, and sometimes rather unnatural results. But now, more people first consider nonsurgical, noninvasive methods that help skin more naturally retain moisture, elasticity, and firmness – a younger appearance without going under the knife.

In a recent blog, I introduced the concept of mesotherapy, a medical practice of injecting patients with customized formulations to treat specific medical conditions, such as arthritis, and for numerous emerging cosmetic applications, such as facial rejuvenation, cellulite treatment, and fat loss. A new mesotherapy treatment for facial rejuvenation is making waves in large metropolitan areas right now, several years after being introduced in Europe, where it became something of a “mini rage.” These treatments are called MesoGlow and MesoLift and are provided by varied practitioners. The technique requires dozens of small needle sticks to deliver the treatment directly into the skin.

It is important to understand that the medications used in such emerging techniques are not regulated by the FDA and are not taught in US medical schools. This has several significant implications: 1) there are no standards for what is injected, or who injects it; 2) the purity of ingredients is not rigorously tested to meet strict FDA standards; and 3) the long- and short-term safety and efficacy are currently anecdotal at best. Consequently, patients for such procedures are often guinea pigs for unproven concoctions.

For example, a number of mesotherapy providers offer blended injectable serums pairing multivitamins such as antioxidants with non-cross-linked hyaluronic acid. This powerful skin hydrator plumps up the area of injection, providing a boost to tired skin. However, this hydration lasts only as long as the hyaluronic acid medication remains in the skin, which is several days at most. (Note: This hyaluronic acid is very different than the cross-linked hyaluronic acid found in facial fillers.)

These customized mesotherapy solutions are generally formulated per physician prescription at compounding pharmacies, which are not required to pass the rigorous good manufacturing practices set forth by the FDA. This is not the case in Europe, where mesotherapy formulations are manufactured by highly regulated pharmaceutical companies and so meet certain standards.

The perceived benefit of mesotherapy rejuvenation is based on the immediate delivery of antiaging elements to nurture skin, delaying signs of aging. However, the actual efficacy of facial rejuvenation treatments such as MesoGlow and MesoLift has not been proven. Researchers in a small clinical trial observed no improvement in skin tone and texture after such treatments.

Yet many customers are very pleased with results, claiming their skin feels better and is more vibrant after treatment. So if it doesn’t work, how did mesotherapy for facial rejuvenation become so popular?

My guess is because it is a quick and easy cosmetic procedure with little down time and a moderate price tag. Patients hope for smoother skin or diminished blemishes and try it instead of more costly (but effective) Botox® injections, laser treatments, and chemical peels. MesoGlow-type treatments cost only $100 to $200, with multiple sessions often recommended for “results.”

When patients report that their facial skin feels “smoother” and “fresher” after facial mesotherapy, it may simply be a result of multiple injections (sometimes hundreds), which stimulate a healing response and may, by itself, generate local growth of collagen and other skin components. But, then again, some people don’t seem to care if it works or not. If it’s a hot, new European procedure like this one is, that alone will get people buzzing.

The European response to mesotherapy for facial rejuvenation shows there is a demand for it. How it will play out in the US remains to be seen. To be most effectively marketed and sold here, it would require a reputable pharmaceutical company to manufacture high-grade, standardized formulations, with tight ingredient inspection and controls. So far, no US company has taken a novel mesotheapy formulation through the rigorous drug approval process.

My advice to you is to wait and see. So far, I’m not impressed with results, and I won’t be comfortable with facial mesotherapy until such treatments are approved by the FDA.

There are plenty of more effective and proven antiaging treatments that I’d suggest first, before putting a patient at risk with an unproven procedure. If you are considering any skin treatment that involves needles, chemicals, or abrasive procedures, be smart and get the advice of your dermatologist first.

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